Clinical Research Directory

Inclusion Criteria: * Age 18 to 70 years * Confirmed diagnosis of HFrEF, NYHA functional class II or III * Documented LVEF ≤40% on echocardiogram within the preceding 6 months, with no subsequent measurement showing LVEF \>40% * Receiving a stable dose of any one of the following for at least 2 weeks before enrolment: loop diuretic, beta-blocker, mineralocorticoid receptor antagonist (MRA) or SGLT2 inhibitor * Considered eligible for sacubitril/valsartan by the treating physician according to standard clinical practice guidelines Exclusion Criteria: * Known hypersensitivity or contraindication to sacubitril or valsartan * Serum potassium \>5.2 mEq/L at screening * Personal or family history of angioedema * Cognitive impairment or any condition that prevents the participant from understanding the study information, completing study procedures, or providing valid informed consent. * CRT or ICD implantation within 6 months before enrolment * Active malignancy diagnosed within the past year (except non-melanoma skin cancer) * Previous heart transplant, current LVAD, or planned transplant/LVAD during the study * Concurrent ACE inhibitor, aliskiren or nesiritide * Pregnant, planning pregnancy, breastfeeding, or woman of childbearing potential not using a highly effective method of contraception * Participation in another investigational drug trial without an adequate washout period, as determined by the investigator * The following may warrant exclusion at the treating physician's clinical discretion: active alcohol or drug abuse; heavy smoking deemed to increase risk; clinically significant asthma, urticaria or severe allergic disorder; blood donation within the past 3 months; HIV, active hepatitis B or C, or positive VDRL (particularly with immunosuppression or hepatic dysfunction); recent or planned major surgery; BMI \<18 or \>40 kg/m²